As the above discussion shows, solicitation and patient abandonment claims are not limitless. Notification can be accomplished by a sign in the reception area, a note in the monthly billing statement, or an advertisement in a local newspaper. Continued, https://www.msbml.ms.gov/sites/default/files/Policies/3-22-19Policies.pdf, Missouri Med. URMC responded by sending breach notification letters to the affected patients and notifying the media. A health care practitioner can terminate a patient relationship at any time, but the practitioner may not abandon a patient and should provide continuity of care in accordance with the prevailing professional standard of care. While it may be convenient to resign shortly before Christmas so that you can spend the holidays at home, it could be a monumental mistake if it results in losing nearly one years worth of retirement benefits. Assuming the physician is leaving the practice on good terms and with ample time to prepare for the departure, the key consideration is ensuring that patients are properly notified in a timely and professional manner. If possible, consider posting your retirement in your local newspaper(s) as well as on your website and/or social media pages (if applicable). In March 2015, the NP was preparing to leave URMC for a position at Greater Rochester Neurology (GRN). The California Medical Board ("CMA") advises that patients should be notified of changes in the medical practice and recommends "that due care should be exercised when closing or departing from a medical practice." Abandonment is the unilateral termination of the physician-patient relationship by the physician without giving the patient adequate notice of such termination and without giving the patient sufficient time to establish a relationship with a new physician. Continued. The settlement arose from events in the spring of 2015. 1. Review all documents you have signed. Typically, a non-competition provision prohibits an employee from joining or starting a competitor business. If a non-solicitation attempted to forbid any treatment whatsoever of patients from the employers practice, then it would likely be unenforceable in Illinois. Laura Hale Brockway is the Vice President of Marketing at TMLT. In fact, you must notify them- you can't just leave and let them find out you're no longer their provider. Contact managed care companies with whom you have contracts. For providers who form more continuous treatment relationships (e.g., surgeons providing post-operative care to a patient following a procedure), patient abandonment liability can be limited by furnishing notice of termination of the relationship. The American Medical Associations Ethical Opinion E-7.03 provides that [t]he patients of a physician who leaves a group practice should be notified that the physician is leaving the group., Health care entities must be prepared for the departure of physicians and other health care professionals. Can a heath care practitioner refuse to treat a patient? If you are asking your partner to leave, you need to know the practices rights and obligations to him or her. Once a decision has been made to discharge a patient from the p ractice, the practice will need to notify the patient of the termination in writing. a physician departing a practice to notify her patients that the physician is leaving, the address of the new practice, and offer the patient the opportunity to have medical records forwarded to the new practice. In addition to sending letters, think carefully about how you will address this topic when you speak with patients. Non-solicitation clauses are a type of restrictive covenant (meaning legally that they forbid a party from doing something). If you had signed a non-compete, you would refer them to the other providers in your practice. Notify Third Parties Dependent upon the provisions of contracts and state law, the insured physician and practice may need to notify various third parties. It is not just a piece of advice but also a legal requirement by several state and federal laws. It is, however, not uncommon for employees to solicit the departing physician prior to departure. Another helpful approach, particularly for specialized physicians, is to provide referrals to nearby practices or physicians offering similar types of care or services. Normal workplace stresses are exacerbated by longer hours, less pay and zero tolerance for error, which can lead to fractured relationships among partners or employed physicians in a group practice. Since most patients do not receive a monthly notice, it is common practice to place a dignified advertisement in two or three editions of the local newspaper notifying the general public, as well as past and present patients., https://apps.ok.gov/osboe/documents/Closing%20DO%20Office.pdf, State advises, If you plan to cease the practice of medicine in Oregon, you are required to ensure safe storage and access to patient records. BUT, the practice has a right to protect its patient list and other confidential data. Dont hesitate to contact an attorney if you have any questions. On the other hand, a notice directed to specific patients that informs them that the provider is leaving the employers practice and identifies a new practice where the patient can receive the same or similar services is much closer to the line of solicitation. Are you a healthcare provider considering a new employment agreement with a non-solicitation clause? Litigating a covenant, either from the employer or employees perspective, is expensive. The comparison is intended to serve as a resource to help retiring physicians and closing practices navigate their obligations and avoid regulatory penalties as a result of the patient notification process. Mailing letters to every patient in your statutory retention window may not be effective either, especially if your state has a baseline of 7-10 years for medical records retention. Drafting the Notification Letter . Proactive [], American Medical Association (AMA) guidelines, https://www.cms.org/uploads/BME_Policy_40-8.pdf, https://drive.google.com/file/d/0B-K5DhxXxJZbZGZUdllNbUFvdDg/view, https://www.ama-assn.org/delivering-care/ethics#Chapter%201:%20Opinions%20on%20Patient-Physician%20Relationships, https://cdn.ymaws.com/lsms.site-ym.com/resource/resmgr/resources/lsms_resource_closingamedica.pdf, http://www.lsbme.la.gov/content/health-care-resources-practitioner, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140270/, https://www.msma.org/guide-to-closing-a-medical-practice.html, https://www.njconsumeraffairs.gov/bme/Pages/FAQ.aspx, http://164.64.110.134/parts/title16/16.010.0017.html, http://www.nmms.org/wp-content/uploads/2018/08/closing_your_practice_2016_revised_-_pcs_0.pdf, https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=9&ch=190&rl=8, https://www.texmed.org/Template.aspx?id=6676, State offers no guidance, but association guidelines available. At the mediation, the single specialty practice initially took the position that: (1) if a patient contacted them asking for an appointment with one of the departing physicians, the practice would . This will ensure that your departure date does not result in unnecessary forfeitures. A threshold requirement for a malpractice claim premised on patient abandonment is that there is a patient-provider relationship. The key is to prevent patients from falling through the cracks because of tensions between the physician and the practice. For sound guidance on regulations and requirements, retiring physicians can call the KBHA at (785) 296-7413. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Retiring members can reference our Retirement Checklist for additional guidelines and to find information about Tribute Plan award payments. While the Board rule does not specify the mode of notification, it would be difficult to ensure patients received notification by a newspaper ad. A. Texas Medical Board (TMB) regulations say a physician leaving a group must notify his or her patients by: In the newspaper of greatest general circulation in each county in which the physician practices or practiced, and in a local newspaper that serves the immediate practice area; and. The American Medical Association's Ethical Opinion E-7.03 provides that "[t]he patients of a physician who leaves a group practice should be notified that the physician is leaving the group . The notice shall provide the patient with 30 days to request a copy of his or her record or to designate where he or she would like his or her medical records transferred and shall request from the patient within 30 days written authorization for the destruction of his or her medical records., http://www.legislature.mi.gov/(S(qm1p2yrrhuxenh2d4yfgk1dd))/mileg.aspx?page=GetObject&objectname=mcl-333-16213, Mississippi State Board of Medical Licensure Policy 3.17 advises, whether by relocation, retirement, disability or death, the patient should be advised of the right to have the medical records sent to the physician of their choice. Clearly, a provider is not susceptible to an allegation of patient abandonment each time arelationship with a patient terminates. Post the notification on the practice website. She can be reached at laura-brockway@tmlt.org. The penalty was the result of a settlement with New York Attorney General Eric Schneiderman. Notify the regulatory and business agencies impacted by your closure, including Centers for Medicare & Medicaid Services (CMS), Drug Enforcement Administration (DEA), health insurers, state medical or business associations, and state medical boards. A clean departure will save you headaches and possibly dollars in the immediate future and in the long run. For example, including the date in which your Drug Enforcement Administration (DEA) license will expire within the notification message could help patients avoid unexpected disruptions in access to life-saving medications. 1997) supports this understanding. A critical criterion for patient abandonment claims is the need for further treatment. Leaving a practice can be a stressful time in any physicians career. The employer pulls in one direction, seeking to draft the non-solicitation clause broadly to protect against internal poaching of clients and staff. Though every clients situation is unique, a good place to start when planning for your practices records after retirement or closure is reviewing the legal guidelines for your state regarding patient notification. Can a medical doctor perform acupuncture? According to, Schneiderman, Other medical centers, hospitals, health care providers, and health care entities should view this settlement as, a warning, and take the time now to review and amend, as, needed, their own policies and procedures to better protect private patient information., Law Enforcement and Healthcare: When Consent, Privacy, and Safety Collide. Notify patients in writing, through a letter carefully crafted with input from practice colleagues or the employing . Sources 1, Required notification of discontinuation of practice. It does not create an attorney-client relationship between our firm and the reader. Abandonment also occurs when a physician leaves the employment of a group practice, hospital, clinic or other health-care facility, without the physician giving reasonable notice and under circumstances which seriously impair the delivery of medical care to patients., https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter16/chap16toc.html&d=, State advises, Publish a notice 90 days before closing a practice in a newspaper with statewide circulation, including information on how patients can get their medical records (when a physician is deceased, the heirs or the estate must give the same public notice within 90 days); Send a letter to patients that have been seen within the past year notifying them of the practice closure., https://health.ri.gov/healthcare/about/closingpractices/, State advises, Doctors should advertise in all papers, and notify all patients (no matter how long ago treated) the letter of closing. Meanwhile, about one in three doctors and other health professionals say they intend to reduce work hours in the next 12 months, according to recently published survey research. However, weve found its always useful to clarify what exactly non-solicitation and patient abandonment mean and what they do not mean. Although he did not directly treat any patients within the restricted geography, the urologist did perform various administrative functions relating to his practice out of a home office with that radius. https://www.texmed.org/Template.aspx?id=6676, The Vermont Guide to Healthcare Law by the Vermont Medical Society advises, In order to avoid a claim of abandonment, the physician should take several steps to terminate the physician-patient relationship. Can Physician Assistants Own Independent Medical Practices? If you are planning to make such a move, or to ask one of your partners to leave, follow these steps to avoid getting burned. Board Rule 540-X-9-.10 states reasonable notification must be provided. For assistance, members of The Doctors Company can contact a patient safety risk manager at (800) 421-2368 or by email. There is no specific time period required. If you are not familiar with your states requirements, contact a health care attorney in your area for advice. When Would My Healthcare Practice Use a Promissory Note? A number of patients called the Medical Center and complained about the letter they received. When possible, the outgoing provider should try to time their exit so that patients can arrange continuity in care.